| NPI | 1699712091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME94159) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M2438) |
| 207L00000X Anesthesiology (Licence: MS 22077) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2012-10-09 |